气管插管致杓状软骨脱位的影响因素及预防措施

The factors and the preventive measures for arytenoid dislocation caused by Intubation.

目的 探讨全麻气管插管致杓状软骨脱位的影响因素以及预防措施。方法 总结 1991年 1月～ 2 0 0 0年 12月医源性杓状软骨脱位 13例的发生原因。结果 在 13例中 ,8例为左侧脱位 ,5例右侧脱位。气管插管操作手法不当是导致杓状软骨脱位的直接原因 ,麻醉过浅、肌松不全明显妨碍插管操作。患者体型因素也增加了这种喉损伤的机会。结论 全麻期间发生杓状软骨脱位的原因很多 ,气管插管操作规范。

Objective To assess the factors and the preventive measures for arytenoid dislocation caused by intubation.Methods The causes of the arytenoid dislocation were analyzed in 13 cases from Jan. 1991 to Dec. 2000.Results Of all patients, 8 had the displacement of the left arytenoid and 5 the one of right arytenoid. The incorrect manipulation for intubationis was the direct factor for this complication. The inadequate depth of anesthesia and (or) insufficient muscle relaxation affected obviously the manipulation of intubation. In addition, the patient′s somatotype was favourable to his arytenoid injury.Conclusion During general anesthesia, many factors were responsible for arytenoid dislocation. It is possible for anesthetist to prevent patient from having arytenoid dislocation by intubating correctly and by making anesthetic depth adequate.